ALWAYS LOOK FOR THE POSTIVE

1. ALWAYS LOOK FOR THE POSTIVE “When it is dark enough, you can see the stars.” -Persian proverb

2. Diseases of Digestive SystemOral cavityEsophagusStomachSmall BowelLarge BowelLiverPancreasRectumAnus Chapter 2

3. GI system • GI tract: mouth -> anus • Accessory structures • Teeth, tongue,_____________, liver, pancreas, ______________

4. Diseases Oral cavityEsophagusStomachSmall BowelLarge BowelLiverPancreasRectumAnus

6. Periodontal Disease is plaque-induced inflammation of gums Progressive gingivitis, gingival hyperplasia, peridontitis with vertical bone destruction, and peridontitis with horizontal bone destruction The end result is _____________________ Periodontal means “around the tooth” Etiology Food particles, bacteria collect around gum line and form plaque (tartar) Causes gingivits Minerals in saliva collect in plaque and harden to form ___________ which adheres to teeth 3-5 d to harden Causes bad breath Protects the bacterial environment Oral Diseases: Periodontal Disease

7. Oral Diseases: Gingivitis Gingivitis—earliest signs of Periodontal Disease Involves only the ______________ of the gums _______________ inflammation of gums Gingival hyperplasia (may also be breed- or drug-related) Cause—accumulation of tartar on teeth Tartar is conducive to bacterial growth _____________ produced by bacteria damage tooth attachment and cause inflammation

8. Without intervention, gingivitis progresses to: Periodontitis— _____________ condition: Loss of gingival root attachment (receding gums) Alveolar bone _____________ Loss of teeth Oral Diseases: Periodontal Disease alveolar bone

9. Normal Gingiva

10. Periodontitis—irreversible condition: Alveolar bone resorption Gingivitis—reversible; earliest signs of Periodontal Disease Oral Diseases: Periodontal Disease Mild tartar more tartar severe tartar >50% bone loss Mild gingivitis more gingivitis _____________ tooth is loose ____________ min bone loss moderate bone loss should be pulled

11. Calculus builds up under gums Separates teeth from gums to form ___________, which encourages more bacteria to accumulate and grow Bacteria secrete toxins/enzymes that cause detachment of tooth from bony socket WBC’s invade area and release their enzymes to destroy bacteria These enzymes also cause detachment of tooth from bone Pockets get deeper and deeper Weakens bone Can cause ___________________________ Other sequellae Bacteria enter blood stream Can cause micro-abscesses in liver, kidneys Cause _______________ on heart valves Oral Diseases: Periodontal Disease

12. Oral Diseases: Periodontal Disease Iatrogenic mandibular fracture resulting from excessive force extraction of a lower molar tooth

13. Oral Diseases: Periodontal Disease Signs Halitosis Reluctance to chew hard food Pawing at mouth Oral pain; personality changes _________________________________ Increased salivation Facial swelling; tooth loss Dx Complete oral exam Presence of tartar (plaque) on teeth

14. Oral Diseases: Periodontal Disease Rx Dental scaling with ultrasonic scaler Root scaling/planing (below gum line) with thin ultrasonic tip; ____________________ Gingival curettage with curette against inner surface of gums (gingival pocket’s diseased soft tissue inner surface) Polishing to smooth the tooth surface and prevent tartar buildup Irrigation to remove diseased tissue and plaque

15. Oral Diseases: Periodontal disease DOXIROBE GEL controls ___________ and promotes rebuilding of periodontal structures *contains Doxycycline, an antibiotic

16. Oral Diseases: Periodontal Disease Plaque prevention gel Applied once a week

17. Oral Diseases: Periodontal Disease Client info Good oral hygiene is necessary for all pets ______________________________ Routine dental cleanings performed at veterinarian’s Treat gingivitis early before irreversible lesions occur Extractions are sometimes necessary to clear up infections _______________ food may promote better dental health by removing tartar before it calcifies Once it calcifies, tartar must be removed professionally http://www.youtube.com/watch?v=-qnbJZWycdg&feature=PlayList&p=480B67A7E8907594&playnext_from=PL&playnext=1&index=5

18. Oral Trauma Causes (many) Falls, fights (bites), burns, blunt trauma (HBC) ______________________ in cats Fractured: hard palate, mandibular symphysis Tongue injury from biting own tongue, dog fight, eat from tin can in garbage, FB(Foreign body) Cats playing with needles, thread; strangulate tongue Electrical, chemical burns Gunshot wounds, fish hooks Bones lodged in teeth Fx mandible—cat; HBC

19. Oral Trauma Signs History or signs of head trauma Increased salivation Inability to close mouth; due to: Pain Fracture/dislocation FB Reluctance to eat (same reasons) Presence of foreign object Dx PE of oral cavity X-ray to r/o embedded FB

20. Oral Trauma Rx Depends on type of trauma Control bleeding Provide _______________________ IV fluids pain relief Insure adequate airway Repair/extract damaged teeth, fracture Client info Like kids, if animals can get into trouble, they will Discourage chewing on electric cords Don’t leave caustic/toxic chemicals out Keep pets in fenced yard or on leash when outside Animals still eat well without entire tongue

21. Oral Neoplasia Relatively common in cats and dogs; __________________ and squamous cell carcinoma most common Signs Depend on location and size of growth More common in males Abnormal food prehension Increased salivation Tooth loss Oral pain Dx Histology of mass X-rays to r/o metastasis Biopsy of LN to r/o metastasis Squamous cell carcinoma (Upper R 3rd incisor) Bone loss around lesion Rostral maxillectomy was curative

22. Oral Diseases: Oral Neoplasia • Benign neoplasia • Papillomas • ______________

23. Oral Diseases: Oral Neoplasia A gingival (buccal mucosa) melanoma involving a dog's caudal mandible and temporomandibular joint region. Above: An invasive feline oral squamous cell carcinoma (courtesy of Jon Slattery)

24. Oral Neoplasia Rx Surgical excision Partial removal of mandible/maxilla if bone is involved Radiation therapy Chemotherapy Client info Px for malignant tumors is ________________ even with aggressive therapy Benign lesions have good Px Animals (esp cats) with bone removed may need nutritional support (feeding tube)

25. Oral Diseases http://veterinarydentistry.posterous.com/

26. Salivary Mucocele Accumulation of excessive amounts of______________________ Most common lesion of salivary glands in dogs; rarely seen in cats (following trauma) Cause is unknown (tight collar, choke chain??) Signs Slowly enlarging,_______________, fluid-filled swelling on neck or under tongue Reluctance to eat Difficult swallowing Blood-tinged saliva Respiratory distress

27. Salivary Mucocele Dx Clinical signs Paracentesis shows thick, _________________ Rx Aspirate fluid Surgical drainage Remove salivary gland; insert Penrose drain x 7 d Client info Cause is unknown; trauma may be involved Without removal of gland, excess fluid will continue to accumulate Some cases may resolve spontaneously Removal of mandibular salivary gl

28. Lip-Fold Dermatitis Often seen in breed with _________________(spaniels, setters, St. Bernard, bulldogs, bassets) Constant moisture in the folds from saliva causes bacterial growth Food, hair, moisture cause irritation, erythema, and fetid odor Signs Halitosis Collection of debris in lower lip fold Dx Clinical signs Rx Dental cleaning Clip hair Clean out folds (food) Medicated wipes Sx is ________________

29. Lip-Fold Dermatitis Client info Keep lip folds ______________ (for the rest of animal’s life!!) Flush/clean lip folds with 2.5% benzoyl peroxide shampoo chlorhexidine malaseb pledgets (chlorhexidine + miconazole) Drying agents like corn starch several times a day Good dental hygiene will help prevent it